A new study published in theFrontiers in Cardiovascular Medicineshowed that wearable technology for monitoring pulmonary congestion in heart failure (HF) patients decreased the risk of both hospitalization and mortality by 37%. Hospitalizations for HF have a considerable predictive impact. They are expensive, intrusive, and have no discernible mortality benefit, yet, implanted hemodynamic monitors can identify early congestion. Although it may not be a reliable indicator of decompensation, body weight is frequently tracked as an outpatient for the onset of congestion. An alternative to intrusive methods of monitoring traffic is provided by wearable technology. Therefore, in comparison to conventional therapy, this meta-analysis was carried out to investigate the effectiveness of wearable devices in lowering HF hospitalizations and death. PRISMA criteria were followed in conducting a systematic review and meta-analysis. Trials comparing wearable device-guided care with conventional HF therapy were found by searching the PubMed, MEDLINE, EMBASE, and Cochrane databases. Hospitalization for heart failure, worsening heart failure events (hospitalization or ED visit for heart failure), and all-cause death were among the outcomes. Random effect models were used to do meta-analyses of total (first and recurring) events. All the 958 individuals who were enrolled at the time of or within 10 days after being discharged from a hospitalization for heart failure were included in 4 trials that satisfied the inclusion criteria. When compared to standard treatment, wearable device-guided therapy led to a 40% decrease in HF occurrences (RR: 0.60, 95% CI: 0.42–0.86, p = 0.005) and a 41% decrease in hospitalizations for HF (RR: 0.59, 95% CI: 0.41–0.87, p = 0.007). The wearable monitoring arm saw a 26% decrease in all-cause mortality (RR: 0.74, 95% CI: 0.55–0.99, p = 0.04). Wearable monitoring resulted in a 37% reduction in the composite outcome of HF hospitalization and death (RR: 0.63, 95% CI: 0.44–0.91, p = 0.04). All-cause mortality and HF hospitalizations were decreased in newly admitted patients when treatment for HF was directed by wearable technology that measures pulmonary congestion. Overall, across the range of EF, HF therapy guided by wearable devices that identify pulmonary congestion decreased HF hospitalizations and mortality. When transferring treatment from the acute to the home environment, wearable monitoring may offer more protection against unfavorable outcomes. This approach proved successful in patients with characteristics indicating a worse prognosis, such as a recent hospitalization. Murray, C. P., Kenny, A. P., O’Sullivan, N. J., Murphy, R. T., & Curtain, J. P. (2025). Efficacy of wearable devices detecting pulmonary congestion in heart failure: a systematic review and meta-analysis. Frontiers in Cardiovascular Medicine, 12, 1612545.https://doi.org/10.3389/fcvm.2025.1612545